| NPI | 1124624143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2020039457) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS TMP-159764) |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2021-09-28 |